📝 Overview
The Write-Offs Report shows money that your office expected to collect but chose not to. Every write-off represents a decision to forgo some amount of income — whether that is a discount given to a patient, a balance that was forgiven, or an amount written off during insurance EOB posting. This report helps you see where that money is going, how much of it is expected versus unexpected, and whether write-offs are being used appropriately.
To access the Write-Offs Report, go to Reporting > All Reports Beta, select a location, and click Write-Offs under Daily Reports.
💡 What Counts as a Write-Off
There are three main types of write-offs in ChiroHD, and all three appear on this report:
1. 🧾 Account Write-Off
An account write-off is applied as a bulk amount against a patient's overall balance — it is not tied to any specific service or inventory item. This type of write-off is applied using the Write-Off button in the transaction modal.
Example: A patient has a $200 outstanding balance. The office decides not to pursue it and applies an account write-off to clear it.
Account write-offs appear as their own separate line item on the patient's ledger.
2. ✏️ Inline Write-Off
An inline write-off is applied directly to a specific service or inventory item on the ledger — it represents a discount given on that particular charge. Inline write-offs appear as a small notation under the charge amount on the ledger, showing the original price and the amount written off.
Example: A service is priced at $95. The office gives the patient a $20 discount, making the charge $75. The $20 is recorded as an inline write-off tied to that service.
⚠️ Important: Inline write-offs are only available on cash services — meaning services assigned as fully patient responsible. You cannot apply an inline write-off to a service that is being billed to insurance, as it is not permissible to give a discount on insurance-billed services.
3. 🏥 Insurance Write-Offs (Contractual Write-Off / Disallowed Amount)
Insurance-related write-offs occur during the EOB posting process and come in two forms:
Contractual Write-Off (Disallowed Amount): The difference between what you billed for a service and the allowed amount set by the insurance company. Because you are in-network with that insurer, you are contractually required to write off this difference. This maps to the Disallowed column on the EOB posting screen.
Example: You bill $50 for an adjustment. The insurance company's allowed amount is $30. The $20 difference is a contractual write-off — money you are required to forgo as part of your in-network agreement.
Insurance Write-Off: Any remaining balance written off after all expected EOBs have been posted. This maps to the Write-Off column on the EOB posting screen.
Example: After insurance pays $7 and the patient copay accounts for $5, there is $8 remaining. The office writes off that remaining $8 rather than pursuing it.
⚠️ When to write off on the EOB posting screen: Only write off the remaining balance when you have posted the EOB from the last insurance company expected to pay on that claim. If the patient has a secondary insurance, do not write off the remaining balance when posting the primary EOB — wait until the secondary has also been posted. Writing off too early means you are telling ChiroHD that no further payment is expected, which is inaccurate if another payer is still outstanding.
📋 Write-Off Reasons
When applying either an account write-off or an inline write-off, ChiroHD prompts you to select a reason. These reasons are used to organize and categorize write-offs on the report. The available reasons are:
Account Write-Off
Location Promotion
Organization Promotion
Employee Discount
Hardship
Insurance Write-Off
Nutrition Discount
Professional Write-Off
Prepay Write-Off
Scholarship
Time of Service
Note: Write-off reasons are not customizable — offices cannot add, edit, or remove reasons from this list. The selection is up to the office to decide how they want to define and categorize their write-offs. There are no strict definitions for which reason must be used in which situation.
📄 Summary vs. Detail
Summary
Shows total write-off amounts grouped into two categories: Ledger Write-Offs (which includes account write-offs and inline write-offs combined) and Insurance Write-Offs (contractual and insurance write-offs from EOB posting)
Best for a quick total overview
Detail (PHI — requires appropriate access)
Breaks down each write-off by patient name and amount
Insurance write-offs are separated into Insurance Write-Offs (from the Write-Off column on EOB posting) and Contractual Write-Offs (from the Disallowed column on EOB posting)
Best for identifying exactly which patients and services the write-offs are tied to
🔽 Report Filters
Filter | What It Does |
Start Date / End Date | Sets the date range for write-offs to include |
Export options: PDF and CSV
⚠️ Why Write-Offs Matter to Your Practice
Every write-off is a choice to not collect money. That has a direct impact on your practice's revenue:
Every write-off = less income collected
High write-offs can make a practice appear less profitable — even if the reason for the write-offs is legitimate (like contractual insurance adjustments)
Write-offs that are being used to zero out ledger errors or skip collections on valid balances are a sign of a process issue, not a financial strategy
There are legitimate reasons to have write-offs — contractual insurance adjustments are required, discounts for promotions or hardship are reasonable, and small uncollectible balances may not be worth pursuing. The report helps you see whether your write-offs fall into expected categories or whether there is a pattern that warrants a closer look.
🔧 How This Report Works With Other Reports
The Write-Offs Report is most useful when run alongside the Sales Report:
The Sales Report shows the full default billed amount of services and inventory items — it does not account for write-offs
The Write-Offs Report shows what was written off
Running both together and subtracting write-offs from sales gives you a closer estimate of the true collectible value of what your office has rendered
Example workflow: Sales Report shows $10,000 in services billed. Write-Offs Report shows $1,500 in write-offs. The closer-to-real collectible estimate is approximately $8,500 — though this still does not account for fee schedule allowed amounts.
This is also a report commonly requested around tax time. Offices often provide their accountant with the Write-Offs Report alongside the Tax Information Report and Sales Report to give a complete picture of billed amounts, taxes applied, and amounts adjusted off.
❓ Common Questions
What is the difference between an account write-off and an inline write-off? An account write-off is a bulk write-off applied to a patient's overall balance — it is not tied to a specific service. An inline write-off is a discount applied directly to a specific service or inventory item on the ledger. They both appear on the Write-Offs Report under Ledger Write-Offs, but they represent different actions.
Why can't I apply an inline write-off to an insurance service? It is not permissible to give a discount on a service that is being billed to insurance. Inline write-offs are only available on cash services — those set as fully patient responsible.
What is a contractual write-off? A contractual write-off is the difference between what you billed for a service and the allowed amount set by your insurance contract. Because you agreed to that allowed amount when joining the insurer's network, you are required to write off the difference. It appears in the Write-Offs Report Detail view as a Contractual Write-Off line, sourced from the Disallowed column on the EOB posting screen.
When should I write off the balance during EOB posting? Only after all expected insurance payments have been posted. If the patient has both primary and secondary insurance, wait until the secondary EOB has been posted before writing off any remaining balance.
Why do I have a lot of account write-offs on ledgers? A high volume of account write-offs — especially if they are zeroing out balances — can indicate that staff are using write-offs to clear ledger discrepancies rather than correcting the underlying issue. It is worth reviewing whether write-offs are being used intentionally or as a workaround for ledger errors.
Can offices customize the write-off reason list? No. The write-off reasons are set by ChiroHD and cannot be added to, edited, or removed by individual offices.
✅ Key Takeaways
The Write-Offs Report shows money the office chose not to collect, grouped into Ledger Write-Offs (account and inline) and Insurance Write-Offs (contractual and insurance from EOB posting).
There are three types of write-offs: account write-offs (bulk balance forgiveness), inline write-offs (service-level discounts, cash services only), and insurance write-offs (contractual and remaining balance write-offs during EOB posting).
Inline write-offs cannot be applied to insurance-billed services — only cash services.
When posting EOBs, only write off the remaining balance after the last expected insurance company has paid — not before secondary insurance has been posted.
Write-off reasons are categories only — they do not change the function of the write-off, and they are not customizable by the office.
The Detail view breaks down write-offs by patient and separates insurance write-offs from contractual write-offs.
Run this report alongside the Sales Report to get a closer estimate of true collectible revenue, and alongside the Tax Information Report for accountant-ready documentation.
📌 Conclusion
The Write-Offs Report gives your office visibility into money that has been intentionally set aside — whether due to insurance contracts, patient discounts, or forgiven balances. Understanding the difference between the three types of write-offs, and knowing when each one is appropriate, helps you use the report accurately and recognize when write-off patterns may point to a process that needs attention.
For the most complete financial picture, plan to run this report alongside the Sales Report and Tax Information Report.